On Synergistic Effect Of Ultrasound Contrast Agent In Ultrasound Ablation For Treating Uterine Fibroids And Safety Evaluation

Research background:Uterine fibroids is the most common benign tumor of women ofchildbearing age, the incidence rate of20-40%,50%of whom shows clinicsymptoms and needs treatment. As a non-invasive therapy, high-intensityfocused ultrasound (HIFU) can ablate uterine fibroids safely and efficiently,it gains more and more recognition. Clinic researches are conductedfocusing on how to further enhancing the ablation effect of HIFU andreducing the treatment time. The ultrasound contrast agent (SonoVue)mainly composed of sulfur hexafluoride microbubbles can change theacoustic environment. A retrospective study showed that the use ofultrasound contrast agent (SonoVue) in ultrasound ablation treatment ofuterine fibroids may play a synergistic effect,however, prospective studyreported has not been carried out for observing the efficiency of theultrasound contrast agent (SonoVue) enhancing HIFU ablation of uterinefibroids. Objective:Study synergistic effect of ultrasound contrast agent (SonoVue) inHIFU ablation of uterine fibroids and safety evaluation.Materials and methods:By applying the HIFU tumor treatment system (JC200) developed byChongqing Haifu Technology Co., Ltd., selecting80cases diagnosed assolidary uterine fibroid in Suining Central Hospital, which were randomlydivided into contrast agent group (40cases) and non-contrast agent group(40cases), the contrast agent group received intravenous injection of1.5mlultrasound contrast agent (SonoVue) both before and after HIFU therapy,while the non-contrast agent group only received intravenous injection of1.5ml ultrasound contrast agent (SonoVue) after HIFU therapy, theoccurrence rate of nodular gray change, EET, ablation rate, as well asoccurrence rate of immediate adverse reaction during and after HIFUtherapy of the contrast agent group and the non-contrast agent group werecompared.Result:(1)Among the40patients of the contrast agent group,33(82.5%)revealed nodular gray change in fibroid ablation, EEF (ultrasound energyconsumed by ablating unit volume of focus group) was9.1±9.9(range:0.4-56.8) J/mm3, the ablation rate is90.4±8.3(range:66.4-100)%; amongthe40patients of the non-contrast agent group,20(50.0%) revealednodular gray change in fibroid ablation, EEF was12.9±15.7(range: 1.5-71.1) J/mm3, the ablation rate is82.8±13.3(range:53.4-100)%, the Pvalues were0.002,0.029,0.006, all <0.05, statistically significant.(2) During the HIFU therapy for the contract agent group: radiatingpain12.5%, sacrococcygeal region pain60%, hot skin57.5%, treatmentarea pain57.5%, groin pain5.0%, without hip crease pain, anal pendantexpansion2.5%, pubic symphysis pain2.5%, hip pain2.5%; for thenon-contrast agent group: radiating pain87.5%, sacrococcygeal region pain72.5%, hot skin77.5%, treatment area pain67.5%, groin pain17.5%, hipcrease pain10%, anal pendant expansion2.5%, without pubic symphysispain and hip pain, the P values were0,0.469,0.056,0.356,0.077,0.051,1,0.314,0.314, all>0.05,without significant difference.(3) Immediately after HIFU therapy for the contrast agent goup:without fever, lower abdominal pain47.5%, sacrococcygeal region pain25.0%, without lower limbs paresthesia, vaginal drainage5.0%, skindamage2.5%, without anal pendant expansion; for the non-contrast agentgroup: without fever, lower abdominal pain42.5%, sacrococcygeal regionpain30.0%, without lower limbs paresthesia, vaginal drainage7.5%,without skin damage, anal pendant expansion2.5%, the P values were1,0.653,0.617,1,0.644,0.314,0.314, all>0.05,without significantdifference.Conclusion:The ultrasound contrast agent (SonoVue) can enhance the HIFU ablation effect in treating uterine fibroids, with fewer energy consumption,free from adverse reaction, boast favorable clinical application value,deserve further promotion and research.